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We aimed to elucidate the underlying mechanisms influencing Oral nutritional supplementation (ONS) adherence in postoperative patients with gastric cancer (GC) by developing a structural equation model.
ONS represents a cost-effective nutritional intervention for postoperative patients with GC, with its efficacy largely dependent on sustained patient adherence over time. However, the interrelationships among the quality of discharge teaching (QDT), readiness for hospital discharge (RHD), medication beliefs and adherence to ONS remain inadequately understood.
A convenience sample of 505 postoperative patients with GC was recruited from January 1, 2023, to December 1, 2024, for a cross-sectional survey conducted at a tertiary-grade A specialised oncology hospital. The data of this study were subjected to descriptive analysis, Harman's one-way analysis of variance, Pearson correlation analysis and mediation effect analysis.
The STROBE checklist was employed for reporting in the study.
Pearson correlation analyses revealed that all four variables were significantly interrelated. Structural equation modelling showed that medication beliefs had the strongest correlation with ONS adherence (β = 0.589), followed by readiness for hospital discharge (RHD) (β = 0.557) and quality of discharge teaching (QDT) (β = 0.523). The structural equation model demonstrated a robust overall fit.
There was a significant chain mediation effect through RHD and medication beliefs. For the development of targeted intervention strategies to improve ONS adherence, future research should prioritise enhancing QDT, optimising RHD and strengthening patients' medication beliefs.
To help nurses and nursing managers formulate intervention measures to improve QDT, RHD, medication beliefs and ONS adherence in postoperative patients with GC.
To investigate the correlation between intensive care unit (ICU) nurses' demographic characteristics, teamwork, moral sensitivity and missed nursing care.
Teamwork, moral sensitivity and missed nursing care are important health challenges among ICU nurses. Clarifying the relationship between variables is benefit to improve the quality of patients care. Nevertheless, a comprehensive conceptualisation of the relationship between teamwork, moral sensitivity and missed nursing care remains lacking.
A cross-sectional design.
This study follows the STROBE checklist. ICU nurses were recruited by two hospitals between November 2023 and January 2024, in Shandong Province, China. The demographic characteristic questionnaire, teamwork perceptions questionnaire, moral sensitivity questionnaire–revised version into Chinese and the Chinese version of the missed nursing care questionnaire were used for investigation. Multiple linear regression was used to clarify the factors affecting missed nursing care. Pearson correlation was used to test the correlation between teamwork, moral sensitivity and missed nursing care.
The level of missed nursing care for ICU nurses was low, with overall mean score of 37.49. Missed nursing care for ICU nurses in the labour dispatch were much higher than nurses with the contract system and personnel agency (p < 0.05). The 12-h shifts of ICU nurses also influenced missed nursing care. Furthermore, teamwork has a positive relationship with moral sensitivity (r = 0.653, p < 0.001).
Hospital and nursing managers should pay attention to the clinical sense of belonging of ICU nurses, reasonably set the working shifts, which will help to reduce the occurrence of missed nursing care.
It is recommended that nursing managers should invest in strategies to enhance nurse teamwork and implement a 12-h shift pattern, which can alleviate moral distress and improve quality of care.
No patient or public contribution. (The data of this were collected from nurses and not related to patients. They were informed of the research process and precautions, signed informed consent.)
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